Provider Demographics
NPI:1568856953
Name:DENTAL DELIGHTS PC
Entity Type:Organization
Organization Name:DENTAL DELIGHTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILPI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-430-6238
Mailing Address - Street 1:770 BOYLSTON STREET
Mailing Address - Street 2:APT#4D
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02199
Mailing Address - Country:US
Mailing Address - Phone:617-933-9053
Mailing Address - Fax:
Practice Address - Street 1:770 BOYLSTON STREET
Practice Address - Street 2:APT#4D
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199
Practice Address - Country:US
Practice Address - Phone:617-933-9053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty